Endometriosis – how yoga can help

Irina Verwer shares her personal experience of living with endometriosis and how yoga has helped her manage the symptoms.

Irina Verwer_endometriosis

I have recently been diagnosed with endometriosis and its sister adenomyosis but have been dealing with the effects of these conditions since the age of eleven. Therefore, I know first-hand how much they can affect daily life. I also know how hard it can be to find something that helps to ease the pain. For me, yoga has been a life saver. While it’s not a cure for endometriosis, yoga can both take the edge off the pain and help to deal with the other every day discomforts caused by this condition.

What is endometriosis?

To understand why yoga helps when you’re suffering from endometriosis, it’s helpful to know what endometriosis is in the first place. 

Endometriosis is a disorder where tissue similar to the lining of the uterus (endometrial-like) grows outside of the uterus. These lesions are different in both structure and behavior from the normal endometrium which is shed during your menstruation. Endometriosis tissue can cause pain, infertility, and organ dysfunction due to inflammation, invasion into structures in the body, and scar tissue.

Approximately 1 in 10 people assigned female at birth have endometriosis. It is extremely rare in people assigned male at birth. Symptoms are often dismissed as “bad cramps” leading to an average of delay of 10 years and 8 doctors to be diagnosed with endometriosis.

Although your health care provider may suspect endometriosis, surgery is required to confirm a diagnosis. 

There are many theories that seek to explain endometriosis. Most likely, it is a combination of an embryonic origin (tissue that you were born with) plus other genetic and environmental factors. The commonly taught theory, that endometriosis is caused by the backflow of menstruation (“reflux menstruation”), has been largely debunked but is still used as a base for many of the treatments offered.

Symptoms of endometriosis

Education and awareness can lead to early detection. This is why it’s critical for you to know, understand, and be vocal about your symptoms. These are some of the symptoms of endometriosis:

  • Very painful periods (pelvic pain, cramping, lower back and abdominal pain)
  • Pain during ovulation or two weeks after your period
  • Leg pain or neuralgia (nerve sensations) associated with your cycle
  • Hip pain and/or back pain
  • Shoulder/chest pain or shortness of breath with your cycle
  • Pain during or after sex 
  • Thick blood clots (often dark) with your period
  • Painful bowel movements or painful urination
  • Excessive bleeding
  • Fatigue and chronic pain
  • Diarrhoea and constipation
  • Bloating
  • Nausea and vomiting
  • Unusual urinary frequency, retention, or urgency
  • Allergies and other immune-related issues
  • Infertility and pregnancy loss (though many people can still have children) 

How is endometriosis treated?

In some cases, surgery is successful in removing endometriosis completely. For many others, though, it does not fully eradicate the condition. In these cases, as well those where surgery is not an option, the focus shifts to managing the symptoms. This is often done with hormone treatment, painkillers, and the contraceptive pill. In addition to that, or as a stand-alone way of managing the symptoms, certain lifestyle tools may make living with endometriosis easier. These include Chinese herbs and acupuncture, dietary changes, therapy, massage, and yoga.

How yoga can help symptoms of endometriosis

Research suggests that yoga does help to manage endometriosis symptoms. A group of Brazilian researchers randomly divided 40 people with the condition into two groups: those with a gentle Hatha yoga practice and those going about their regular lives without an additional practice. For two months, the group that practiced yoga attended two ninety-minute classes per week.

At the end of the study, the two groups were compared. The people who practiced yoga reported significantly less daily pain, as well as an improved sense of well-being, according to results published in January 2017 in The Journal of Alternative and Complementary Medicine.

For many people with endometriosis, their nervous system and immune system are under attack all the time. The body heals best when it’s not in a stressed fight-flight-freeze state. This is why yoga can be so beneficial for when you’re suffering from endometriosis.

Relaxing the body by practicing yoga can also make your pain feel less intense. A practice that includes gentle asanas, meditation, and breathing exercises helps to calm your mind, which reduces how you experience discomfort. On top of that, certain yoga poses are known to relax tension in the abdomen and pelvis and increase blood flow to the region.

Not all yoga helps though

If you are looking for ways to ease the symptoms of endometriosis, it’s helpful to know that not all yoga helps to ease the pain. In fact, there are some styles that make it worse. This is especially the case with more vigorous styles, such as Ashtanga or Power yoga, which often build up too much heat and energy in the abdomen and pelvic area. This can lead to flare-ups, especially when you practice these styles while you’re on your period.

Slower styles of yoga, such as Restorative yoga, Yin yoga, and Hatha yoga are, for most people with endometriosis, a much better fit. These styles all help to gently create more space and relaxation in the pelvic area, as well as calm the mind.

Soft belly

Throughout my years of dealing with endometriosis, as well as my experience of leading workshops, retreats, one-on-one sessions and group coaching sessions focused on hormonal health and menstrual disorders, I’ve found a few poses (see below) that are particularly beneficial for those who are suffering from severe menstrual or pelvic pain. 

Usually when you’re experiencing pain in a certain area of your body, you’ll try to contract around that area, in an attempt to ‘disconnect’ and therefore feel less pain. Unfortunately, that doesn’t work. Contracting and ‘disconnecting’ actually creates more pain, not less. As counterintuitive as this might feel, relaxing the belly and breathing towards the belly eases the pain.

Instead, see if you can allow your belly enough space for the breath to move in. So with every inhalation, the belly will move forward. With every exhalation, the belly draws back in.

Even if you don’t practice any poses, because you simply lack the energy at the moment, you’re in too much pain, or any other reason, take some time to soften your belly completely whenever you’re experiencing pain. See if you can also relax your jaw, as tension in the jaw often reflects tension in the pelvic floor. The more you can relax your jaw, the more your pelvic floor will relax too. 

Which yoga poses can help?

So, which are the poses that help most to ease the pain that comes with endometriosis? That differs from person to person, and from cycle to cycle. In general though, focusing on grounding poses is a good idea. Hip openers create more space to breathe and are therefore very effective too. 

For most people with endometriosis, Vajrasana, Malasana, and Supta Baddha Konasana offer relief.

Vajrasana

Vajrasana

To come into this pose, kneel down and sit with your buttocks on your heels. (unlike Virasana or Hero’s pose where you sit between your heels).

When you sit in Vajrasana, the way your heels touch your buttocks stimulates two acupuncture pressure points, helping to ease your pain. Twisting very, very gently in this pose may further relieve your pain.

Malasana

Malasana

Standing with your feet wider than hip-width apart, bend your knees and lower your hips, coming into a low squat. You can modify Malasana or Squat pose by placing a rolled-up blanket under your heels, or by leaning against a wall.

Malasana is great for menstrual cramps, endometriosis pain, and digestive problems. It opens up your pelvic area, increases flexibility and circulation in this area.

Supta Baddha Konasana

Supta Baddha Konasana

Lie on your mat with the soles of your feet touching, knees bent. Place your hands on your lower belly and breathe towards your hands.

Supta Baddha Konasana or Reclined Butterfly pose deeply relaxes the muscles in your pelvic region and inner thighs and helps to loosen the ligaments, tendons, and other soft tissues that surround the hip joints.

When you’re in one of these poses, you can stay there for up to ten minutes per pose. Staying in each pose for a longer period of time will allow you to soften tight muscles and connective tissue in and around your abdomen and pelvis, deepening the pose and its benefits.

Practice with me

Here on EkhartYoga, you can find a pretty wide selection of classes to support you throughout your entire cycle.
A class that I created especially with those suffering from endometriosis in mind, is Soft & Slow – for your cycle. Additionally, I created this menstruation playlist where you’ll find all of my favourite practices to help you gently sail through your cycle. It even includes a few cooking videos!

More information

Want to learn more about endometriosis and adenomyosis? Nancy’s Nook is a good place to start. I’ve used some of their findings for this article, including the studies about yoga and endometriosis. Know your Endo is another informative website. I used (part of) their list of endometriosis symptoms for this article.

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Irina VerwerIrina Verwer is a yoga teacher, holistic coach, vegan chef and writer of two yogic cookbooks. Very grateful for and inspired by all of her teachers, Irina has created a unique style of teaching that is both intense and gentle.